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Critical appraisal of clinicopathological features of anaplastic carcinoma small intestine – A rare case report
Journal of Solid Tumors , 2012, DOI: 10.5430/jst.v2n3p71
Abstract: Anaplastic carcinoma is an extremely rare variant of small intestine adenocarcinoma with only an occasional case having been reported in literature to date. We report a case of 46 year old male who presented with an endophytic tumor in ileum extending through full thickness of intestinal wall, with invasion into mesenteric fat. Microscopically, the tumor showed a biphasic growth pattern unlike conventional adenocarcinoma. The present case discusses the histomorphology of anaplastic carcinoma small intestine, its histochemical and immunohistochemical profile and the differential diagnosis of this rare but highly aggressive pathological entity.
Stromal Expression of CD10 in Invasive Breast Carcinoma and Its Correlation with ER, PR, HER2-neu, and Ki67
Vandana Puri,Manjula Jain,Shaji Thomas
International Journal of Breast Cancer , 2011, DOI: 10.4061/2011/437957
Abstract: CD10 is a cell surface zinc-dependent endopeptidase, which degrades many bioactive peptides. CD10 expression in tumour stroma is associated with biological aggressiveness of many epithelial malignancies. To date, only one study has correlated with expression of CD10 with well-known prognostic markers of breast, that is, ER, PR, HER2-neu, and tumour grade; however, its correlation with ki67 is still not studied. The aim of this study is to evaluate stromal CD10 expression in breast carcinoma and to examine its correlation with ER, PR, HER2-neu, and Ki67. Methods and Results. CD10 expression in fifty patients was assessed by immunohistochemistry and scored as negative, weak and strong. CD10 was found to be positive in stroma of 40/50 (80%) cases. Stromal CD10 showed positive correlation with tumour grade, HER2-neu ( ), and ki67 ( ), negative correlation with ER and PR. Conclusions. Hence CD10 expression correlated strongly with well-established negative prognostic markers, that is, HER2-neu and ki67 positivity, ER/PR negativity, and higher tumour grade, thus indicating that CD10 can be used as independent marker indicating poor prognosis and can be used as target for the development of novel therapies. 1. Introduction Breast cancer is one of the commonest cancers among women globally. Each individual tumour varies with respect to invasive and metastatic potential as well as growth rate. The prognosis of a given lesion is related to member and types of oncogene activated. Various markers have been used to study the oncogene expression or amplification. The clinical course of the neoplasm can be altered by directing therapy against overexpressed oncogenes. Well-established prognostic factors including stage of tumour, histological grade, lymph node status, ER/PR status, and HER2-neu are routinely studied in every case of breast cancer. Stromal markers are now emerging as novel markers in assessing the prognosis of invasive breast cancer and have not been studied extensively till date. Stroma plays a key role in modulating tumour invasion and metastasis. A better understanding of stromal contribution to cancer progression will identify specific signals that promote growth, dedifferentiation, invasion, and ectopic survival of tumour cells and eventually result in the identification of new therapeutic targets for future treatment [1]. This justifies the study of new stromal marker CD10 in the prognosis of invasive breast carcinoma. CD10 is a zinc-dependent metalloproteinase that has been called common acute lymphoblastic antigen (CALLA). It is frequently
Critical appraisal of FNAC in the diagnosis of primary papillary carcinoma arising in thyroglossal cyst: A case report with review of the literature on FNAC and its diagnostic pitfalls
Agarwal Kiran,Puri Vandana,Singh Smita
Journal of Cytology , 2010,
Abstract: The incidence of primary papillary carcinoma arising in thyroglossal cyst is rare and occurs in <1% of thyroglossal cysts. Even rarer is its diagnosis by pre-operative fine needle aspiration cytology (FNAC). Only 15 such cases diagnosed by FNAC have been previously reported in the literature. In this article, cytomorphology of the current case is presented along with a review of the literature on FNAC and its diagnostic pitfalls.
Primary “Botryoid” Embryonal Rhabdomyosarcoma in Mesentery
Türk Patoloji Dergisi , 2011,
Abstract: Rhabdomyosarcoma is a soft tissue neoplasm arising from primitive embryonal mesenchyma. Embryonal rhabdomyosarcoma mostly affects children younger than 10 years of age, but it also occurs in adolescents and young adults. Pleomorphic rhabdomyosarcoma is a rare variant that almost always arises in adults older than 45 years of age. Mesentery is a rare site for botyroid embryonal rhabdomyosarcoma and on extensive search we found only one case of a botryoid rhabdomyosarcoma in a child of 2 years. We report a rare case of botyroid embryonal rhabdomyosarcoma occurring in the mesentery of a 30 year old female.
Angiographic Evaluation of Coronary Collateral Circulation Patterns in Patients with Coronary Artery Disease Requiring Surgical Revascularization  [PDF]
Deepak Puri, Nidhi Puri
World Journal of Cardiovascular Diseases (WJCD) , 2017, DOI: 10.4236/wjcd.2017.711036
Abstract: Background: Coronary artery disease is highly prevalent in India with onset at a younger age. Coronary collateral circulation plays an important role in protecting myocardium from infarction, preserving myocardial contractility and reducing cardiovascular events. The objective of the present study is to assess the pattern of coronary collateral circulation in known cases of coronary artery disease with correlation to age, gender and degree of occlusion. Method: This is a retrospective study done on 200 preoperative angiograms in patients with coronary artery disease. Patients were classified according to age, gender and degree of obstruction in major vessels. Collateral vessels were graded according to the Rentrop classification. Patients with collaterals were further classified on the basis of intensity of collaterals into 3 groups: those with no collateralization (Grade 0), poor collateralization (Grade 1) and those with adequate collateralization (Grade 2 - 3). Results: Collateral development was seen in 175 (87.5%) angiograms. Collaterals were seen in 66% for left anterior descending (LAD), 44.5% for circumflex (LCx) and 70.5% for right coronary artery (RCA) block. Coronary collaterals between LAD and posterior descending artery (PDA) via ventricular septal branches were most common pathways. Adequate collaterals were seen in 53% males and 29.3% females (p < 0.001), 53.14% in patients of age > 50 years and in 32% in cases with age < 50 years (p = 0.014) and 54.8% cases with arterial obstruction > 90%. Conclusion: Collateral circulation between LAD and PDA via ventricular septal branches is the commonest pathway to develop. Although prevalence of LAD occlusion is higher but collaterals develop more for RCA occlusion. Adequate collaterals develop more frequently in males, cases above 50 years and in vessels with >90% obstruction.
A Rare Case of Congenital Rhabdomyosarcoma with Review of the Literature
Gautam Bir Singh,Rubeena Arora,Deepak Kumar,Manjula Jain,Vandana Puri
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/518952
Abstract: We present a rare case of rhabdomyosarcoma of lip in a neonate with multiple lesions within the head and necksub site hitherto unreported in the medical literature. This case report also reviews the scant medical literature on neonatal rhabdomyosarcoma. 1. Introduction Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm of the skeletal muscle origin. The tumour accounts for 4–8% of all malignancies in children of less than 15 years of age [1]. It has a bimodal peak incidence, the first occurring at the age of 2–6 years and the other occurring at adolescence [2]. RMS also has a strong male preponderance. Though congenital RMS has been reported in the medical literature, it is extremely rare [1, 3]. With this background, we present a case of neonatal rhabdomyosarcoma with unusual clinical presentation. 2. Case Report An 11-day-old neonate presented to the “Paediatric Otorhinolaryngology OPD” of our Kalawati Saran Paediatric Hospital, attached to Lady Hardinge Medical College, New Delhi, India, a tertiary care university teaching hospital with a swelling in the upper lip since birth and complaint of difficulty in suckling. In general the baby was irritable and always crying. A large ovoid swelling was seen in the upper lip and adjoining part of upper face. The lesion involved the anterior nares causing stenosis. On the buccal surface, the skin over the swelling was normal with no sinus, punctum, or ulceration. The alveolus was free of the swelling. The swelling measured in maximum dimensions. The swelling was tender, firm in consistency and the skin over it was indurated in patches with engorgement of veins (Figure 1). A differential diagnosis of odontogenic tumour, dermoid, solitary fibromatosis, gingival granular cell tumour, rhabdomyosarcoma and neurofibroma was considered. Figure 1: Clinical photograph of the patient with lesion in upper lip. Patient underwent CT scan and MRI scan which revealed soft tissue intensity lesions in the lip, orbit and submandibular region (parapharyngeal space) (Figures 2 and 3). Fine needle aspiration and biopsy from the lip lesion revealed population of round cells which were arranged in clusters as well as dispersed cell population. These cells were small with scant-to-moderate amount of cytoplasm, round-to-oval nucleus, fine chromatin, and inconspicuous nucleolus. No cytoplasmic vacuoles or rosettes were seen (Figure 4). Immunocytochemistry was put up for LCA, CD99, Desmin and Myogenin to confirm the diagnosis. Leucocyte common antigen (LCA) was strongly positive for Desmin and Myogenin (Figures 5 and 6). On the
A Survival Approach to Prediction of Default Drivers for Indian Listed Companies  [PDF]
Vandana Gupta
Theoretical Economics Letters (TEL) , 2017, DOI: 10.4236/tel.2017.72011
Abstract: The objective of the research study is to identify the key predictors that can explain default risk for Indian listed companies using survival analysis. The author has applied the semi-parametric Cox proportional hazard model to test the impact of financial ratios, capital market ratios, macro-economic variables, size and age of companies, and the ownership structure of promoters to a dataset of 859 companies panning across 10 sectors. Unlike traditional models on default prediction, survival models focus on time to default as the dependent variable. The empirical findings reveal that return on capital employed (ROCE), return on net worth (ROE), interest coverage ratio, exchange rate volatility, GDP growth rate, stock index, promoters holdings % and the percent of shares pledged are all significant predictors of default. Among the market variables, it is seen that beta and the ratio of market value of equity/book value of debt are statistically significant variables in explaining default risk. The empirical findings also generate the hazard ratio for each covariate which examines the predicted change in the hazard for a unit increase in the predictor. The author extends the research by applying the market-based KMV structural model to obtain continuous observations of default probability and regressing the same against all the?covariates (Gupta et al.,
Open Market Repurchases and Signaling Hypothesis  [PDF]
Vandana Gupta
Theoretical Economics Letters (TEL) , 2018, DOI: 10.4236/tel.2018.83041
Abstract: This paper analyzes the impact of open market repurchase (OMR) route of buyback on the stock prices of a data set of 30 Indian listed firms which had gone for buyback in the FY16. The author has applied event study methodology to calculate abnormal returns and cumulative abnormal returns on stocks using BSE 500 as market index. The returns are calculated for 20 days prior and post buyback announcement to test for information signaling hypothesis. The analysis shows that average abnormal return (AAR) on the date of announcement is -0.23 percent while cumulative abnormal return (CAR) is about 5.72 percent on the announcement date with an overall CAR 3.44 percent for 40-day event window. The research findings reveal that unlike tender offers, OMR does not lead to a signaling effect as there is the insignificant impact on stock prices. Market reaction to buyback offer is in contradiction to signaling hypothesis predictions. The results of the study imply that the information related to the announcement of the buyback is already reflected in the share price. This also throws light on the growing maturity and efficiency of the stock market of India. Analyzing the signaling effect through OMR reveals that rather than signaling hypothesis, market reaction to buybacks is better explained by free cash flow hypothesis.
Predicting Accuracy of Valuation Multiples Using Value Drivers: Evidence from Indian Listed Firms  [PDF]
Vandana Gupta
Theoretical Economics Letters (TEL) , 2018, DOI: 10.4236/tel.2018.85052
Abstract: The objective of this research study is twofold: 1) to evaluate the prediction accuracy of four valuation multiples across three sectors for Indian listed firms and 2) to identify the fundamental drivers for these multiples. The valuation multiples identified for this study are: price to earnings (P/E), price to book value (P/BV), price to sales (P/S) and enterprise value to earnings before interest, depreciation, tax and amortization (EV/EBIDTA) and the sectors taken are steel, banking and automobile. Multiple regression methodology is followed with the valuation multiple as dependent variable and the value drivers as independent variables, to get predicted multiples on 470 firm observations. By regressing the multiples on fundamental variables, the best suited multiple for each sector and the key drivers of the multiple are obtained. The empirical findings based on root mean square error (RMSE) and Theil coefficient reveal that least prediction errors are observed in P/S and EV/EBIDTA for the automobile sector, EV/EBIDTA for the steel sector and P/BV for the banking sector. It is also observed that the significant variables that explain these multiples are beta, return on equity (ROE), return on capital employed (ROC), dividend payout ratio (D/P) and net profit margins (NPM). These findings are in line with the derivation of fundamental drivers for each multiple as explained in Gordon model. Damodaran: 2007 [1]. The present work contributes to emerging market literature on equity valuations and attempts to compare valuations based on market approach using value drivers. A comparison of forecasts with actuals helps in recommendations to buy/sell/accumulate/hold for equity investors and is also pertinent for market participants and financial regulators.
Evaluating the Accuracy of Valuation Multiples on Indian Firms Using Regularization Techniques of Penalized Regression  [PDF]
Vandana Gupta
Theoretical Economics Letters (TEL) , 2019, DOI: 10.4236/tel.2019.91015

This research study is conducted on companies in three prominent sectors: Automobile, Banking and Steelall three diverse and affected by different economic, fiscal and financial policies. The author Gupta [1] attempts to extend the scope of study done earlier using simple linear regression for valuation of companies. Highlighting the limitations of linear regression: multicollinearity and normality, the present study is conducted by applying regularization techniques of machine learning. Ridge regression, LASSO and elastic net techniques are employed to underscore this commonality of the set of valuation multiples. These regularization techniques are tested on data of Indian listed firms spanning across twelve years from FY 07 to FY 2018 and the four multiples identified for the study are 1) price to earnings (P/E), 2) price to sales (P/S), 3) enterprise value to earnings before interest tax depreciation and amortization (EV/EBIDTA) and 4) price to book value (P/BV). The empirical findings are based on root mean square errors and learning curves, which corroborate the least prediction errors in P/S for auto sector, EV/EBIDTA for steel sector and P/BV for banking sector. As a byproduct, the author has also been able to pinpoint which one of the variables among them is the most important. The study concludes that, in spite of differing sectors, a certain set of common variables can be used across them to effectively assess company valuation (valuation multiples). The present work contributes to emerging market literature by evaluating the key multiples that drive sectors to apply non-traditional regression techniques.

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